California Supplemental Training

For the EAR PIERCING TECHNICIAN

STUDEX

The world’s largest ear piercing manufacturer

BLOODBORNE PATHOGENS SAFETY LAWS

• 1992 - Cal/OSHA’s Bloodborne Pathogens Standard went into effect.

• Cal/OSHA found ear piercing to be exempt

from the program. • 2012- California Safe Body Art Act went into

effect. • The Safe Body Art Act includes a requirement

that any person piercing an ear with a mechanical stud and clasp piercing device shall receive one hour of training.

TRAINING REQUIREMENTS The California Safe Body Art Act (AB 300) requires ear piercing professionals to receive one hour of training before performing any ear piercing procedures. The training shall include at least the following:

• Proper use of the mechanical stud and clasp ear piercing device.

• Types of bloodborne pathogens and the prevention of the transmission of bloodborne communicable diseases.

• Proper hand hygiene.

• The safe and sanitary use of single-use equipment, including, but not limited to, gloves, towels, and disinfectant wipes.

TRAINING OBJECTIVES After completing this training, you should be able to:

• Comply with the requirements in Article 7 of the Safe Body Art Act.

• Use the mechanical stud and clasp ear piercing device correctly.

• Identify common bloodborne pathogens, and give a general explanation of their routes of transmission, epidemiology, and symptoms.

• Recognize tasks and procedures that have a potential for causing exposure to bloodborne pathogens, and explain how to use engineering controls, work practices and personal protective equipment to reduce exposure.

DEFINITIONS

• “Blood” means human blood, human blood components, and products made

from human blood. • “Bloodborne Pathogens” means pathogenic microorganisms that are present

in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV).

• “Occupational Exposure” means reasonably anticipated skin, eye, mucous

membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.

• “OPIM” means other potentially infectious materials. OPIM includes any body fluid that is visibly contaminated with blood such as saliva or vomit.

• “Universal Precautions” is an approach to infection control. According to the

concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, HCV, and other bloodborne pathogens.

When a law is written, words are defined as they will be used in the law. The following terms are defined as they are used in this training course.

HOW PATHOGENS ENTER THE BODY

Image of food

Coughing and Sneezing Consuming Food Contaminated with

Feces

Post Piercing Touching with Unwashed Hands

AIR INGESTION CONTACT

PATHOGENS OF INTEREST TO EAR PIERCING TECHNICIANS

Viruses • Hepatitis B • Hepatitis C • Human Immunodeficiency Virus (HIV) Bacteria • Staphylococcus aureus (MRSA) • Streptococcus • Pseudomonas • Mycobacterium tuberculosis (TB)

WHAT IS HEPATITIS?

Hepatitis is inflammation of the liver.

A healthy liver is smooth with an even color.

Inflammation can lead to cirrhosis, a chronic degenerative disease in which normal liver cells are damaged and are then replaced by scar tissue. Hepatitis may also eventually lead to liver cancer.

Healthy Liver

Liver with Cirrhosis

COMPARISON OF TYPES OF HEPATITIS

Hepatitis A B C

Source of virus Feces from infected person

Blood from infected person

Blood from infected person

Entry to body Fecal - oral Through skin or mucous membranes

Through skin or mucous membranes

Chronic disease No Yes Yes

Prevention Pre/post exposure immunization;Safe practices

Pre/post exposure immunization;Safe practices

No available immunization; Safe practices

HEPATITIS B • Transmission: Exposure to blood

infected with the hepatitis B virus. Common mode of transfer – touch.

• Symptoms: Flu-like symptoms such

as loss of appetite, fever, fatigue, nausea, vomiting, abdominal pain, dark urine and jaundice.

• Identification: Blood test.

• Treatment: Vaccination, Interferon

and other antiviral medications.

• Prevention: Safe practices. Hepatitis B vaccination.

Hepatitis B antibodies Public Health Image Library

HEPATITIS C • Transmission: Hepatitis C is spread when

blood from a person infected with the hepatitis C virus enters the body of someone who is not infected.

• Symptoms: Flu-like symptoms such as loss of appetite, fever, fatigue, nausea, vomiting, abdominal pain, dark urine, and jaundice. More than half of those infected with hepatitis C have no symptoms.

• Identification: Blood test.

• Treatment: Interferon alpha or a combination of Interferon and Ribavirin.

• Prevention: Safe practices. No vaccine yet.

Hepatitis C virus particles

PhD Dre at en.wikipedia

HUMAN IMMUNODEFICIENCY VIRUS (HIV)

• Transmission: Direct injection of HIV infected blood into the blood-stream (from a syringe or needle) into a non-infected person, or by infected body fluids coming into contact with mucous membranes or damaged tissues.

• Symptoms: Some people experience a flu-like illness with symptoms such as fever, headache, fatigue, and enlarged lymph nodes. Many infected people then enter into a period that can last for years when they have no symptoms at all.

• Identification: Blood or saliva test.

• Treatment: HIV is a chronic medical condition that can be treated, but not cured. Many medications have been developed to extend and improve the quality of life of infected persons.

• Prevention: Safe practices. There is no vaccine.

HIV virus Public Health Image Library

STAPHYLOCOCCUS AUREUS

• Transmission: Contact with person who has MRSA or by contact with

items contaminated with MRSA. • Symptoms:

– Cellulitis – inflammation of the skin – Impetigo – blistered lesions or abraded skin with honey-colored crust – Folliculitis – infection of the hair follicle (like a pimple) – Furunculosis – deeper infection below the hair line – Carbuncle – multiple adjacent hair follicles and substructures are affected – Abscess – puss-filled mass below skin structures – Severe Lung Infection – Bloodstream Infections or Pneumonia (less common)

• Treatment: Mild to moderate infections may be treated with Bactroban

ointment or by having a doctor drain the infection. More severe MRSA infection may be treated by intravenous (IV) therapy

with Vancomycin.

Staphylococcus aureus is called MRSA when it is resistant to Methicillin.

PSEUDOMONAS • Pseudomonas is a bacteria

commonly found in soil, water, plants, and animals.

• Pseudomonas aeruginosa has been found to be the cause of approximately 95% of the infections in piercings of the cartilaginous areas of the ear.

• It is fast growing and can cause severe swelling and pain within days of the infection. Prompt medical treatment is required to prevent permanent damage to the cartilage.

• Pseudomonas can be transmitted by contact with anything that has pseudomonas on it.

MYCOBACTERIUM TUBERCULOSIS • Transmission: From person to person via

droplets from the throat and lungs of people with the active TB disease.

• Initial Symptoms: Most people have no

symptoms when initially infected because the body is able to wall off the infection.

• Active TB Disease Symptoms Include: Loss of

appetite, weakness, fatigue, weight loss, fever, night sweats, paleness, chills, swollen glands, joint pain, hearing loss, diarrhea, chest pain, coughing, and wheezing.

• Identification: A simple skin test and x-rays are used to determine if a person has TB.

• Treatment: Six to nine months of special drugs that kill TB bacteria. NOTE: if all medication is not taken as prescribed, TB germs can become drug-resistant.

ENGINEERING AND WORK PRACTICE CONTROLS

• The purpose of engineering controls and work practice controls is the same: to reduce or minimize employee exposure to bloodborne pathogens.

• The difference between the two types of controls is that one

isolates or removes the hazard from the workplace, while the other reduces the risk of exposure by altering how tasks are performed.

• Shop owners and ear piercing technicians must select and implement appropriate engineering and work practice controls where occupational exposures to blood or other potentially infectious materials may occur.

ENGINEERING CONTROLS

• Single use pre-sterilized studs

and clasps.

• Studs and clasps packaged in blister packs that allow installation of the cartridge into the machine without touching studs and clasps.

• Storage space for piercing instrument that protects it against dust and other contamination.

• Trash pail operated by foot pedal.

• Single use paper towel dispenser.

• Glove dispenser.

• Non-porous, cleanable customer chair and set up area.

Engineering controls isolate or remove the hazard from the workplace. Examples of engineering controls used in ear piercing include:

WORK PRACTICE CONTROLS

• Perform hand hygiene before donning and after removing gloves.

• Thoroughly clean and check the client’s ear for any signs of infection.

• Always wearing appropriate gloves.

• Conduct the client interview and finish paperwork before beginning the ear piercing.

• Keep the piercing area neat and organized.

• Keep client chair, trays, etc. clean.

Work practice controls reduce the likelihood of spreading infection by altering the manner in which tasks are performed.

Examples of work practice controls used in ear piercing include:

PROHIBITED PRACTICES

• No using makeup, lip balm, or lipstick.

• No handling contact lenses.

• No loitering in or near the piercing area.

• No touching of ear post-piercing.

PERSONAL PROTECTIVE EQUIPMENT

• Do not use latex gloves.

• Fresh gloves are to be used for each customer.

• If you leave the procedure area or touch something outside the prepped piercing area, the gloves are to be considered contaminated and the hands must be re-wiped with hand sanitizer and new gloves put on.

Personal protective equipment must be worn by the employee. For purposes of ear piercing, this personal protective equipment is limited to appropriate examination gloves.

HAND HYGIENE

STANDARD PRECAUTIONS

Under Standard Precautions, the following are considered infectious:

• All blood, including dried blood. • All body fluids, secretions, and excretions regardless of whether blood is

visible (except sweat). • All non-intact skin. • All mucous membranes.

• Standard Precautions have been designed for the care of all individuals, regardless of their diagnosis or presumed infection status. Under Standard Precautions, gloves should be worn in every instance of customer contact.

• Standard Precautions are considered the safest method of infection control for ear piercing technicians. Therefore, it is suggested that Standard Precautions be followed for all instances of customer care.

Standard Precautions are a widely recognized method of infection control. Standard Precautions reduce or eliminate potential transmission of infection between the customer and the ear piercing technician.

WORK SITE MAINTENANCE • The owner or ear piercing technician must ensure that the worksite is properly maintained.

• OSHA requires employers to develop and implement a written cleaning and decontamination schedule for the facility.

• This schedule should be based upon: – The area of the facility (common areas, procedure areas, restroom) – The tasks or procedures performed in each area – The type of surface to be cleaned – The type of soil, debris, or contamination that may be present

• The method of cleaning or decontamination must be determined, and must include:

– The type of personal protective equipment to be worn to complete a task (if any) – The cleaning product or disinfectant to be used – Who is to do the cleaning – How often cleaning is to be performed

• This includes accidents—customers getting sick, coughing, throwing up, falling, etc. All precautions applied to actual piercing apply to accidents that need to be cleaned up.

SIGNS AND LABELS

• Federal law requires all products used in your facility to be labeled.

• Also, an up-to-date material safety data sheet (MSDS)

must be maintained on every product used in the facility. • Your hard surface cleaner should be labeled. Most other

pieces of ear piercing equipment come pre-labeled.

WASTE DISPOSAL

• In general, no special handling of waste from ear piercing is required because the wastes are not regulated wastes by definition.

• However, it is always good to check with your local health department for any special ordinances.

CUSTOMER AND EMPLOYEE RECORDS • Under federal law, records involving the public are

considered confidential.

• All customer piercing records are to be stored in a secure locked area for a minimum of five years.

• Training records should be kept with the employee

records for the duration of the employment plus a minimum of three years.

INJURY LOG

• A pre-printed injury log and report form should be kept by the company first aid kit, along with a map to the health clinic or hospital and with a list of all the emergency phone numbers.

• This log should be used for everything from spills to

injuries, and in conjunction with any worker’s compensation injury forms issued by the insurance companies.

• Spills should include a copy of the MSDS for the product

involved.

AFTER CARE • Pre-printed after care

instructions need to be reviewed and signed by every customer prior to an ear piercing. If the customer is under 18 years old, a parent or guardian must sign and be present during the ear piercing.

• The technician is required to answer all questions and give the customer verbal and printed aftercare instructions prior to performing the piercing.

• A signed copy of all after care instructions shall also be maintained by the shop for at least five years in a locked secure location.

Cartilage Ear Piercing Additional Training

• Cartilage piercing performed with a disposable single use, presterilized, stud and clasp applied using a mechanical device is not considered body piercing as long as it is performed on the appropriate portion of the ear.

• Cartilage piercing under ear piercing definition of California code AB300 refers to the upper portion and outer trailing edge of the ear, and not the tragus portion.

• Please see the ear highlighted in figure 7 for a clear understanding on the next slide.

Cartilage Piercing Tutorial

All other handling and care instructions for ear piercing apply. The highlighted area of the ear in figure 7 is the acceptable area for piercing cartilage

QUESTIONS?

Studex Corporation 521 West Rosecrans Ave. Gardena, CA 90248 310-851-9300 Email; training@studex.com Website; www.studex.com